Prescription Refill — a snarl of patient frustration

Patients dearly hate the hassle of requesting refills on medication prescriptions. Why?

  • The prescriber’s office takes days or weeks to respond (low priority).
  • The prescriber’s office requires an office visit, but can’t make an appointment until next month.
  • The patient fears running out of needed medication for asthma or migraine headaches or diarrhea.
  • The prescription has expired or did not have the expected refills.
  • A new insurance plan started
  • The insurance plan calculated the patient still had a day left on the previous refill and says to wait. (patient has something to do tomorrow besides rush to the pharmacy).
  • The person who answers the phone at the prescriber’s office can’t refill low-risk medications. So, a message is left for the physician who is out of the office and back-up physicians don’t do refills.
  • The prescriber’s office says to call the pharmacy while the pharmacy says to call the prescriber’s office.
  • The unnecessary visit to the ER just to get a refill.

It’s so easy for prescriptions to become “out of sync” with prescriber office visits. A cancelled appointment, a doctor’s vacation, a visit for an inter-current illness (a walk-in visit), an “as needed” medication that the prescriber forgot to re-prescribe at the last office visit etc. etc.

The pharmacy is also to blame by ridiculously refusing refills within a few days of running out of medication. And, waiting until the patient shows up at the window to say, “looks like the med is out of stock.”

It’s amazing more patients don’t require a mental health visit after trying to get refills.

According to a 2012 study only a third of primary care practices had a formal renewal policy. The big advantage for patients is quick turn-around for non-hazardous medications (like thyroid or asthma meds). Within the practice the amount of “churn” was less (fewer internal messages and delays). Plus, with a formal policy 100% of the patient charts were checked to verify the medication, allergies, last appointment etc. Another article actually listed medications safe for refill.

Solutions:

  • Give your prescriber a copy of the 2012 study
  • When ever you receive a prescription ask “how many refills and how often?” And, ask for 90 day supplies to minimize refills.
  • Keep a list of when each prescription will run out. Check it frequently and call the prescriber two weeks before the med is needed.
  • Ask your pharmacist if they have “grace” days which allow refills within a week of prescription expiration (use those pharmacies)
  • Know the difference between a refill (an existing prescription with active refills) and a renewal (a new prescription for the same medication)
  • Respect the guideline for prescribers to see patients at least once a year when a patient is taking medications. Keep up to date.
  • When a medication is taken “as needed” or PRN don’t hesitate to make an office visit to clarify when to stop taking or when to change the dose.
  • If a pharmacy is out of stock of a medication ask the pharmacy to transfer the prescription to another one that has the medication.
  • Always call the pharmacy before picking up a new medication to make sure they have it and that insurance will pay for it.
  • When you pick up medications don’t walk away from the pharmacy counter without looking at the medication and label to make sure it’s the right prescription (not some old one with the wrong dose). Pharmacies will not take medications back if you leave the store.
  • If you are notified your prescriber is leaving, check you prescriptions and call the office if you will run out of medications in a few months. Immediately make an appointment with someone new and have copies of your records transferred. Sometimes new appointments must wait for several months.
  • Your prescriber is responsible to maintain and monitor prescriptions — NOT the pharmacist and NOT the insurance company. If the prescriber’s office is not up to the task dump them and give them bad marks on Healthgrades.

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